How Are Popular Diets Affecting Our Patient’s Health?

Written by on July 1, 2014 in Features - No comments

Our patients choose to follow new diets for various reasons including weight loss, lifestyle changes, and ethical reasons. When our patients are researching their new diets they frequently turn to magazines, the Internet, or their favorite celebrity’s of the moment diet for their information.  Unfortunately the information isn’t always accurate nor do our patients always understand the pitfalls of the various diets.  So what are the most popular diets right now and what should we, as physicians, know about them?

VeggieGirlWEBIn 2013 the most googled diet was the paleo diet. This diet became popular among crossfitters and is now moving more into the mainstream population. The paleo diet is a low carb diet that is based on the premise that our bodies are genetically adapted to eating like a caveman. This diet only allows dieters to eat what a caveman would have eaten. Followers of this diet can eat grass-fed meat, seafood/fish, eggs, fruits, vegetables, nuts, seeds, and healthful oils. The founder of the paleo diet, Loren Courdain, PhD, claims that by eating these foods you may lose weight and reduce your risk of developing many types of common chronic illnesses.

So how healthy is this diet and will you lose weight? It is unclear whether long-term weight loss is achieved on this diet as very few studies have been done and the sample size in each has been very limited. Since this diet is high in protein, dieters need to be conscience of making lean protein choices or the fat intake can be quite high. Long-term followers of the paleo diet may need more diligent screening for heart disease as the higher fat intake may put them more at risk for heart disease. The positive aspect of this diet is the high fiber, potassium, and vitamin B-12 intake but since it doesn’t allow dairy it is low in calcium and vitamin D. It is recommended that dieters take calcium and vitamin D supplements to compensate for this as well as a multivitamin.

The juice cleanse diet is another popular diet at the moment, as it has been featured on The Dr. Oz Show and is popular with celebrities. This diet was started by a documentary filmmaker who sought to overhaul his health by drinking only fresh fruits and vegetables for 60 days. It is the 3-day version of this diet that is so popular among people seeking quick weight loss and diet cleanses. This diet begins with abstaining from red meats, sugar, caffeine, processed food, and dairy for 2 days prior to the cleanse. During the entire diet you drink water with lemon and ginger in the morning and in the evening a cup of herbal tea. The 3-day cleanse involves drinking five meals consisting only of juiced fruits and vegetables followed by eating a dinner of fruits and vegetables. At the end of the 3 days you can return to eating 3 meals a day of whole foods, nothing processed, while continuing to have one juice a day and the lemon water and herbal tea.

The consequences of the 3-day cleanse on general health appear to be short term. Dieters mostly complain of fatigue, headaches, irritability, and low blood sugar but these are remedied when food is reintroduced to the body. Short-term weight loss is common but since it is mostly from water loss, long-term effects don’t tend to be noticed. This diet may have severe consequences for people with chronic medical problems especially diabetics and hypertensives. People on blood pressure medications may experience fainting from hypotension and diabetics may become ill from hypoglycemia. Cleanses should be avoided by pregnant and breast-feeding woman.

The most balanced of the popular diets is the Mediterranean diet. This diet is based on the cuisines of the countries bordering the Mediterranean Sea. The emphasis of this diet is fruits, vegetables, whole grains, nuts, legumes, olive oil and spices. It recommends eating fish and seafood several times a week and eating poultry, eggs, cheese and yogurt in moderation. This diet also allows for a small amount, 5oz for women and 10oz for men, of red wine daily. Research has shown that this diet decreases the risk of heart disease by lowering blood pressure and LDL cholesterol. Additionally, a reduction in Alzheimer and Parkinson disease has been noted.

From a health perspective, the Mediterranean diet is excellent. If weight loss is the goal of this diet than it is important to monitor the calorie intake to insure that the intake is less than the calories expended. The fat, protein, and carbohydrate intake is all inline with nutritional recommendations. Calcium and vitamin D supplements may be needed if the dairy intake is low but this may be compensated for if enough fortified foods are eaten. This diet is healthy enough that it can safely become a lifelong way of eating.

It is important to realize that our patients are trying many of the diets that are trending at the moment and they may have unintentional long-term health consequences.  Some diets, like the Mediterranean diet, are healthy long-term food choices. Other diets, especially those that eliminate whole food groups, may have detrimental long-term health effects that patients aren’t even aware of.  Often, if these deficiencies are brought to the patient’s attention, they may be compensated for with nutritional supplements or by making slight alterations to the diet. If diets low in vitamin D and calcium are followed long-term without augmenting them with supplemental vitamin D and calcium it may place patients at higher risk for osteoporosis and thus require earlier screening. High fat diets may require more diligent monitoring for heart disease, even in patients in the normal weight range. Therefore, it is important for us to discover any diets our patients are following so it can be determined how they may be affecting our patient’s health.


By Carrie A. Noriega MD

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